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Endothelial Function, Nitric Oxide, and Cocoa Flavanols

Heiss, Christian MD*; Schroeter, Hagen PhD; Balzer, Jan MD; Kleinbongard, Petra PhD; Matern, Simone BS; Sies, Helmut MD, PhD§; Kelm, Malte MD

Journal of Cardiovascular Pharmacology: June 2006 - Volume 47 - Issue - p S128-S135
Original Articles

Endothelial dysfunction is the pathophysiologic principle involved in the initiation and progression of arteriosclerosis, thus endothelial function serves as a “barometer” for cardiovascular health that can be used for the evaluation of new therapeutic strategies. This review provides an introduction to the concept of endothelial dysfunction, and it explores the importance of this prognostic marker in the context of clinical, dietary interventions in humans. Moreover, we summarize and evaluate the findings of various clinical trials that demonstrated an improvement of endothelial dysfunction in subjects with cardiovascular risk factors after the acute and chronic consumption of flavanol-rich foods, including cocoa products, red wine, and tea.

*Department of Medicine, Division of Cardiology, University of California, San Francisco

Department of Nutrition, University of California, Davis

Division of Cardiology, Pulmonary Diseases and Vascular Medicine, University Hospital RWTH Aachen, Germany

§Institute for Biochemistry and Molecular Biology I, Heinrich-Heine University, Duesseldorf, Germany

Reprints: Dr Christian Heiss, Division of Cardiology, University of California, San Francisco, 513 Parnassus Ave Room S-1136, San Francisco, CA 94143-0124 (e-mail:

© 2006 Lippincott Williams & Wilkins, Inc.